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  • Wirth, ThomasDepartment of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom; Neurology Department, Strasbourg University Hospital, Strasbourg, France; Institute of Genetics and Molecular and Cellular Biology, University of Strasbourg, Illkirch, France (author)

Clinical outcomes after MRI connectivity-guided radiofrequency thalamotomy for tremor

  • Article/chapterEnglish2024

Publisher, publication year, extent ...

  • American Association of Neurological Surgeons,2024
  • printrdacarrier

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  • LIBRIS-ID:oai:DiVA.org:umu-223642
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-223642URI
  • https://doi.org/10.3171/2023.7.JNS222744DOI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • OBJECTIVE: Radiofrequency thalamotomy (RF-T) is an established treatment for refractory tremor. It is unclear whether connectivity-guided targeting strategies could further augment outcomes. The aim of this study was to evaluate the efficacy and safety of MRI connectivity-guided RF-T in severe tremor.METHODS: Twenty-one consecutive patients with severe tremor (14 with essential tremor [ET], 7 with Parkinson's disease [PD]) underwent unilateral RF-T at a single institution between 2017 and 2020. Connectivity-derived thalamic segmentation was used to guide targeting. Changes in the Fahn-Tolosa-Marin Rating Scale (FTMRS) were recorded in treated and nontreated hands as well as procedure-related side effects.RESULTS: Twenty-three thalamotomies were performed (with 2 patients receiving a repeated intervention). The mean postoperative assessment time point was 14.1 months. Treated-hand tremor scores improved by 63.8%, whereas nontreated-hand scores deteriorated by 10.1% (p < 0.01). Total FTMRS scores were significantly better at follow-up compared with baseline (mean 34.7 vs 51.7, p = 0.016). Baseline treated-hand tremor severity (rho = 0.786, p < 0.01) and total FTMRS score (rho = 0.64, p < 0.01) best correlated with tremor improvement. The most reported side effect was mild gait ataxia (n = 11 patients).CONCLUSIONS: RF-T guided by connectivity-derived segmentation is a safe and effective option for severe tremor in both PD and ET.

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  • Goedemans, TacoDepartment of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom; Department of Neurosurgery, Amsterdam UMC, University of Amsterdam, Neurosurgical Center, Amsterdam, Netherlands (author)
  • Rajabian, AliDepartment of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom (author)
  • Dayal, ViswasDepartment of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom; Neurology Department, Auckland City Hospital, Auckland, New Zealand (author)
  • Abuhusain, HazemDepartment of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom; Neurosurgery Department, Royal Hallamshire Hospital, Sheffield, United Kingdom (author)
  • Vijiaratnam, NirosenDepartment of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom (author)
  • Athauda, DilanDepartment of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom (author)
  • Hariz, MarwanUmeå universitet,Neurovetenskaper,Department of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom(Swepub:umu)hama0032 (author)
  • Foltynie, ThomasDepartment of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom (author)
  • Limousin, PatriciaDepartment of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom (author)
  • Akram, HarithDepartment of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom (author)
  • Zrinzo, LudvicDepartment of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom (author)
  • Department of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom; Neurology Department, Strasbourg University Hospital, Strasbourg, France; Institute of Genetics and Molecular and Cellular Biology, University of Strasbourg, Illkirch, FranceDepartment of Clinical and Movement Neurosciences, Unit of Functional Neurosurgery, National Hospital for Neurology and Neurosurgery, UCLH-UCL Queen Square Institute of Neurology, London, United Kingdom; Department of Neurosurgery, Amsterdam UMC, University of Amsterdam, Neurosurgical Center, Amsterdam, Netherlands (creator_code:org_t)

Related titles

  • In:Journal of Neurosurgery: American Association of Neurological Surgeons140:4, s. 1148-11540022-30851933-0693

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